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What is after Fentynal Patch

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:35 AM in Pain Medications
I'm new here and appreciate all the support and advice.

I am going to request my doctor go up on my Fentynal patch from 75 mg to 100 mg every two days (my body seems to metabilize meds real quick). I also take 15mg of oxycodone per day for chronic neck pain.

I have been on dozens of medications in the past and this is now not working and I'm probably looking too far into the future, but what happens when Fentynal doesn't work anymore? What is next up from that? Will I eventually run out of options??

I can't find a doctor to do surgery as I'm still looking, right now I'm getting "it's all in my head" even though you have stenosis, neck of a 75 year old, narrowing of the cervical canal, etc. (I'm 38), they don't think I should be in this horrid pain, but I am.

Anyway, thanks for listening. Any information on the medication options would be great!


  • I used to be on Fentanyl patches too at 100mcg every 2 days and I also metabolized it very quickly. I had to switch to MS Contin because of cost and I was taking 180mg of the ER and 60mg of the IR. Now I'm on 80mg daily of Oxycontin and 40mg of Oxycodone a day.

    Wherever you go from there it's up to your doctor. Fentanyl is 80x's stronger than morphine and it would take a lot to match the amount of mcg's in the patch. It's hard to say which direction your doctor will go when it comes to a new medicine regime but I'm sure they will work with you to get adequate pain relief. Take care
  • As far as the patch goes, you can put more than one patch on at a time if you go over the need for 100. Just thought I would ease your mind.
  • Do you mind if I ask how long you were on the patch? I'm worried about the withdrawl if I go back to strictly pills as I have suffered withdrawl a few times for a couple of hours when I didn't get a patch on in time.

    It seems many of my PM'S patients are on pain pumps and I'm wondering if that is where I will end up I guess. Not sure what they put in those things or if I will end up on one, but I guess if I get desperate enough I will do anything. :''(

    Thanks for responding, I appreciate it!

  • Thank you, yes, I have put two on before when I was on 75 before I got the 75 dose. I wonder how high they go up to 300mg's? lol Gosh, I hope I'm years from that! thanks for reminding me!
  • It depends on the doctor. I was on it long ago and was up to three patches of 100 mcg a day , every 48 hours, but it will take a long time before you wind up there.
    As far as other medications go, that also depends on what other medications you have tried previously , and at what dosages.
    As far as withdrawal, your doctor should be able to switch you over to different medication or combinations that minimize the withdrawal if he has worked with fentanyl before. It can be difficult to switch back, but if he has experience with it, it should not be too difficult.
    If it comes down to implanting a pain pump, they are actually called baclofen pumps I beleive, but the nice thing is that they can use tiny amounts of medications to achieve better pain relief, because it does not have to go through the body tissues, it goes directly into the spinal fluid, so it requires much less of the medication to do a better job. The catheter is threaded from the pump, through the spinal area to the location where they implant the catheter into the spinal fluid. The pump itself is usually implanted in the abdominal area, and anchored to the tissue so that it can scar in , similar to the scs which is usually implanted in the buttocks. It is implanted in the stomach area because it is bigger than the scs.
    Hope that helps,
  • I was on Fentanyl patches for a little over a year. When I switched to Morphine, I didn't experience any withdrawals at all because they did a good job calculating my dose, and I went from 100 mcg of Fentanyl to 180 mg of morphine ER and 60mg MS IR for breakthrough pain.

    I will be having a pain pump surgically implanted soon and I hope this gives me better pain relief. I hope things work out for you too. Take care
  • Meyday,
    I am also considering a pain pump at this point. I joined the Yahoo group for those that have them. They have been truly helpful in discussing the good and bad of the pumps, the medications that can go into the pumps, complications, and you name it that happens with them.
    If you haven't heard of them, it is a great resource.
  • Morning, My experience is that I went from ER Morphine and IR Morph -- to Fent, started on the 25 patch, ramped up to the 75 patch.

    After awhile - I switched back to the IR morph and then dropped the Fent completely. I found that the Fent caused some of the pain for me.

    On the Morph - I have been able to reduce it down further, but there are days that I do too much and I get a pain flare. It takes all of the daily meds that I have to get it under control.

    So - Just to let you know - you don't ness have to have a problem with increasing doses of meds. Tolerance - is based on a medical study that is based on animal behavior. Rats actually and the rats that dont have chronic pain - do have tolerance to morphine.

    If the study was done on rats that did have chronic pain, I am sure that the results would have been different. More in keeping with what we find as patients.

    Cheers - David
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